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The PBI though, does not differentiate controlling or aggressive from anxious overprotective parenting. However, research shows that both forms of overprotective parenting are considered a form of emotional abuse in the sense that prevent children from critical socialization process and therefore from developing the appropriate interpersonal skills and coping strategies 22 , Overall, the most significant finding of our research was the negative association of parental overprotection, on children's involvement to bullying and victimization, as well as to the development of trauma states, through different pathways, a finding which is consistent with other studies Both overprotection as a form of control and lack of care as a form of emotional neglect and lack of support regarding social-emotional development, create high risks conditions for psychological vulnerability.

Our results are consistent with previous studies which have emphasized the impact of dysfunctional relationships with both parents, which are linked with a child's involvement with bullying behaviours [66; 88 ; 41]. Moreover, our results are consistent with recent studies who have also shown that perpetrators experience low levels of parental care and higher levels of overprotection Our research findings are in agreement with those which emphasized the significance of a father's protective role as a defence against peer bullying 15 , 21 and generally about caring parents who are supportive and demonstrate a caring style of parenting that reduces the possibility of their children engaging in bullying behaviours The quality of parental bonding plays an essential role in children's affective and psychosocial development and related disorders In our study, one of the most significant findings regarding both parents overprotective attitude, as perceived by the children, is that consists a significant risk factor for being involved in bullying and victimization and in developing traumatic symptoms through various pathways.

Considering these results in totality, we believe that it is necessary to create a new integrative approach 92 — 94 of examining bullying through the lens of traumatic symptoms and the quality of parental bonding. This helps provide an assessment of deeper psychological interactions that lead to the emergence of negative emotional consequences among victims and bullies, therefore, to be able to design and establish a more comprehensible model of prevention and intervention within family and school contexts that will take into consideration the quality of family dynamics and the quality of parental bonding.

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We also suggest that holistic approaches for tackling bullying should incorporate other experiential interventions , i. Therefore, attempts should be made to help children regain their self-esteem, a sense of emotional control and core identity by helping them better cope with family and school based interpersonal trauma. Hence, we argue that bullying can cause multiple traumatic symptoms, especially when is combined with problematic or dysfunctional family background that create a vulnerability to children or lead them to aggressive counteractions It is important to highlight the significant role of the therapeutic relationship when confronting trauma symptoms, so as to develop the appropriate therapeutic strategies according to the child's developmental stage see Figure 4 or pathway and specific family context in order to re-establish trust and ensure post-traumatic growth.

We attempted to achieve a new understanding regarding bullying phenomena through the lens of traumatic relationships in order to emphasize that bullying comprises an interpersonal trauma that occurs between individuals or groups Therefore, it has been suggested that bullying dynamics are experienced as repeated trauma 59 , 60 , Our study is consistent with previous research results indicating that stressful life events do play a crucial role in the development of depression 96 , 97 , anxiety 98 , and post-traumatic stress symptoms The present study also highlights the need to include problematic parental practices and bonding as stress factors that lead to victimization and bullying, often without any other factor mediation to post-traumatic stress symptoms.

Our study also emphasizes that even children who react in aggressive ways, as bullies, might have experienced problematic or destabilizing relationships with parents. Unfortunately, bullying is often considered a normal developmental experience by several school directors and staff However, the association between bullying and post-traumatic stress symptoms is considered a form of trauma Several health professionals insist that children and adolescents who are exposed to extreme stress are more likely to develop serious mental health issues; therefore, bullying is very often a continuous trauma rather than an acute stressful experience We propose a therapeutic model for addressing bullying that includes post-traumatic stress symptoms; this is based on a previous model, namely the diathesis-stress model, that has received significant empirical evidence , and has contributed to our understanding of how stressful events in the context of relationships can result in depression outcomes and social exclusion Our clinical intervention and hermeneutical model is also consistent with previous results, including Ferguson and Dyck's and Dishion's 95 studies, who argued that it is critical to apply a model that explores the complex relational patterns within family and school contexts and considers the stress and emotional states of a child in order to better clarify the development of aggressiveness.

Bullying is not merely a dyadic problem between a bully and a victim but is rather recognized as a group phenomenon occurring in a social context where several factors operate to facilitate, prevent or hide bullying behaviours 13 , As long as this is the first proposed study in Greece, to examine post-traumatic stress symptomology resulting from bullying and victimization in relation to parental bonding, we believe that our research results can have many useful implications for practice and improve bullying situation in Greek Schools, while percentages fluctuate in similar levels as other European countries.

We propose several implications for clinical and school practice considering the fact that most school interventions focusing on alleviating bullying experiences are currently ignoring the existence of PTSD symptoms. It is important to highlight that schools need to develop interventions to deal with traumatic symptoms in an appropriate way.

Schools must focus on specific students who have manifested symptoms of trauma and provide psychoeducation programs. For instance, school staff could develop better awareness so as to identify the existence of post-traumatic stress symptoms in order to refer students to relevant services i. School personnel could be more vigilant and sensitive to different forms of avoidance behaviours typically higher among girls that possibly mask a child's trauma from a bullying experience.

One of limitation was the self-report nature of our chosen methodology. Future research should also include qualitative methods interviews, etc.

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It also appears that in the Parental Bonding Inventory, latent variables may be perceived differently across different age groups. Thus, further research is needed in order to understand whether such differences are due to actual developmental changes in children's perceptions of the parent-child relationship or conceptual problems pertaining to children's ability to conceive the PBI's theoretical constructs.

Another limitation was the small number of perpetrators sampled. Future research should recruit larger samples in order to offer a more complete picture of bullying phenomena. Given that the present study was carried out for only 1 year, we cannot treat this as a longitudinal analysis.

Future longitudinal research could explore risks and protective factors, in addition to victims' and bullies' personality characteristics that are relevant to development during a longer study period.

Books Identifying, Assessing, and Treating PTSD at School (Developmental Psychopathology at

This indicates that we should clarify a crucial question: whether the manifestation of post-traumatic stress symptoms is the result of a bullying experience or if children who experienced trauma in the past are more likely find themselves in bullying situations. Future research should be more analytical and qualitative in order to examine comorbidities and other essential elements, including family risk and protective factors and the perceived role of masculinity in a society, as boys typically display higher percentages of all forms of bullying.

We also need to examine the effect of cultural issues and ethics, social norms, and the role of each therapeutic approach in order to address bullying in schools and the community. Written informed consent was obtained from parents of participating adolescents and children. All participants provided written consent or assent before completing the questionnaires. All parents of subjects gave written informed consent in accordance with the Declaration of Helsinki.

SP wrote the first draft of the manuscript, and developed and performed the statistical analysis in conjunction with EK and TG.

EK reviewed and edited the manuscript and approved the final version of the manuscript. The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.


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I would like to thank Dr. Maria Georgiadi for her continuous encouragement, support and valuable guidance during the writing of the paper. Berger KS.

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Twenty years' research on peer victimization and psychosocial maladjustment: a meta- analytic review of cross-sectional studies. J Child Psychol Psychiatry. Bullying, depression, and suicidality in adolescents.


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Complex Trauma and its Effects on Child Development

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Books Identifying, Assessing, and Treating PTSD at School (Developmental Psychopathology at

JAMA Psychiatr. A multivariate analysis of youth violence and aggression: The influence of family, peers, depression, and media violence. J Pediatr. Bullying at school—An indicator of adolescents at risk for mental disorders. Variations in peer victimization: relations to children's maladjustment. In Juvonen J and Graham S, editor. Psychiatric disorders and the use of mental health services among children involved in bullying.

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